Does nutritional support contribute to mitigating the financial burden faced by TB-affected households?

Abstract

Introduction: Costs for nutritional supplements and food were the main driver of costs incurred by TB-affected households in Lao People's Democratic Republic. This study assessed the impact of nutritional counselling and support on costs incurred by TB-affected households.

Methods: We conducted longitudinal data collection of costs, income, and coping mechanisms of TB-affected households within an intervention study providing nutritional counselling and support for people diagnosed with TB and having a body mass index (BMI) <18.5 kg/m². Data collection tools were adapted from the WHO's generic national TB patient cost survey questionnaire to fit a longitudinal study design. Costs were considered catastrophic when they exceeded 20% of annual household income before TB.

Results: A total of 268 people treated for drug-susceptible TB were included in the analysis, and the prevalence of BMI <18.5 kg/m² was 38%. The intervention group had significantly lower nutritional supplement costs and direct non-medical costs after TB diagnosis than the observation group. The intervention group had less progressive catastrophic costs (+23.3 percentage points) than the observation group (+30.9 percentage points).

Conclusion: Nutritional counselling and support were significantly associated with a reduction in the proportion of TB-affected households facing catastrophic costs due to TB.

Keywords: Laos; catastrophic costs; patient costs; tuberculosis; undernutrition.

Figure 1.

Percentage of TB-affected households facing costs >20% of annual household income by study group and body mass index at TB diagnosis.

Figure 2.

Percentage of TB-affected households facing costs >20% of annual household income by TB treatment phase.